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Tobacco smoking portends worse functional outcomes after acetabular fracture

Natasha M Simske¹, Isabella M Heimke¹, Alexander Rascoe¹

¹Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, OH, USA.

Archives of Orthopaedic and Trauma Surgery

|April 17, 2025

Abstract

Introduction:

Modifiable patient-related factors contribute to morbidity and functional outcomes after acetabular fracture. This study will investigate the relationship between tobacco smoking and patient-reported functional outcomes after acetabular fracture.

Materials And Methods:

A retrospective cohort study of 770 patients with 782 acetabulum fractures was performed following operative (n = 535, 68%) or non-operative (n = 247, 32%) management. Musculoskeletal Function Assessment (MFA) scores were assessed a minimum of 12-months after injury in 37.5% of patients.

Results:

Tobacco smoking was pervasive with 44% current users and 14% former users. Current tobacco smokers had higher associated MFA scores, when compared to former and never smokers (42.7 vs. 36.5 and 26, p < 0.001). On linear regression analysis, history of tobacco smoking (current or former) was a risk factor for higher, worse outcomes on the MFA (B = 9.86, p = 0.02).

Conclusions:

Current or former tobacco smoking was predictive of worse patient-reported functional outcomes scores after acetabular fracture.

Level Of Evidence:

Level III, Prognostic.

Keywords:

Acetabular fracture Acetabulum Complication Functional outcome Patient-reported outcome Smoking Tobacco

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